My daughter, Megan, is twenty-one and has a diagnosis of both autism and autoimmunity. One of the main behavioral symptoms that Megan began to exhibit nineteen years ago was obsessive compulsive disorder (OCD). It is not an easy life by any means as OCD can dominate too many of her days. Meg regressed after each vaccine as a toddler but had a profound change in health and behaviors after her MMR vaccine. She developed a full body rash, fever, stopped eating, had numerous, daily episodes of green diarrhea, lost eye contact, became isolative,--- and then obsessed with holding a magnetic letter in each hand 24/7. More medical issues developed for example, chronic constipation, Gastroesophageal reflux disease (GERD), and seizures over these past years. Megan has been nonverbal since that regression. Many with an autism diagnosis have OCD and similar health issues. The immune system continues to be unraveled more as the big player in an autism diagnosis yet some still habitually describe autism as a genetic misfit. OCD is a factor in much of this. There seem to be patterns that need to be examined:

Obsessive-compulsive disorder (OCD) occurs worldwide, with common features across diverse ethnic groups and cultures. It affects approximately 2% of the population and is associated with substantial social, personal, and work impairment.1,2……Moreover, a number of other psychiatric and neurologic disorders have similar phenomenological features, can be comorbid with OCD, or are sometimes even conceptualized as uncommon presentations of OCD. These include the obsessive preoccupations and repetitive behaviors found in body dysmorphic disorder, hypochondriasis, Tourette syndrome, Parkinson's disease, catatonia, autism, and in some individuals with eating disorders (eg, anorexia nervosa).4-1……three to five symptom dimensions,19 with the most commonly identified solution including four factors: (i) contamination obsessions and cleaning compulsions; (ii) aggressive, sexual, religious, and somatic obsessions with checking-related compulsions; (iii) obsessions regarding symmetry, exactness, and the need for things to be "just right" paired with compulsions relating to ordering, arranging, and counting, and (iv) hoarding obsessions and compulsions.

Kanner Unfortunately Missed the Immune Dysfunction

Dr. Leo Kanner met those first eleven children, born in the 1930’s , that he would then diagnose in his 1943 paper, AUTISTIC DISTURBANCES OF AFFECTIVE CONTACT . Being a psychiatrist may have clouded his ability to recognize any of the medical issues that those children had vs the psychiatric issues that he loved to study. We here at Age of Autism continue to point out those health issues as we believe they lead both to causation and cures. Kanner did not see the connections that are so clear today but instead used Freudian logic to blame the parents. It is important to get the clues that Kanner missed in his own writings about those first eleven, such as these, describing obsessions and compulsions:

Usually he winds up with an obsessed interest in the things he was afraid of.

Most of his actions were repetitions carried out in exactly the same way in which they had been performed originally.

There were also innumerable verbal rituals recurring all day long.

He immediately proceeded to turn the lights on and off.

At 4 years, 11 months, his first move in entering the office (or any other room) was to turn the lights on and off.

His boarding mother reported a number of observations that indicated compulsive behavior.

All these and many other things were not only repetitions but recurred day after day with almost photographic sameness.

Repetitious as a baby, and obsessive now: holds things in hands, takes things to bed with her, repeats phrases, gets stuck on an idea, game, etc., and rides it hard.

But he himself liked to pull blinds up and down, to tear cardboard boxes into small pieces and play with them for hours, and to close and open the wings of doors.

…he gently stroked his mother's leg and touched it with his lips. He very frequently brought blocks and other objects to his lips. There was an almost photographic likeness of his behavior during the two visits.

He has gradually shown a marked tendency toward developing one special interest which will completely dominate his day's activities.

Yesterday, when looking at a picture, he said many times, "Some cows standing in the water." We counted fifty repetitions, then he stopped after several more and then began over and over.

He immediately spotted a train in the toy cabinet, took it out, and connected and disconnected the cars in a slow, monotonous manner. He kept saying many times, "More train-more train-more train." He repeatedly "counted" the car windows..

..obsessive questions about darkness and light.

When he is interested in a thing, you cannot change it.

He developed an obsession about feces,

The whole performance was very repetitious.

Mild obsessive trends were reported, such as pushing aside the first spoonful of every dish.

There was very marked obsessiveness. Daily routine must be adhered to rigidly; any slightest change of the pattern called forth outbursts of panic. There was endless repetition of sentences.

She insists on the repetition of the same routine always. Interruption of the routine is one of the most frequent occasions for her outbursts. Her own activities are simple and repetitious.

OCD=Repetitive Behaviors=Microbiome

Since autism has been historically and still today, often diagnosed solely on behaviors, it is important that we stress the many GI issues that children can have as they may not be CO-MORBID but instead could be THE EPICENTER of autism and also the OCD that manifests. .

The word REPETITIVE has been one of the triad symptoms diagnosing autism but I would like to challenge that word as OCD may be a better fit for what we are actually seeing. Here is an example of that:

Although children with autism frequently complain of gastrointestinal (GI) problems, the link between gut health and autism is not entirely clear. Researchers have now begun to trace a connection between the two.

Children with autism who have constipation are often also plagued by compulsive or repetitive behaviors, a core feature of autism, finds a study published 29 November in the Journal of Autism and Developmental Disorders….The researchers initially noticed that many of the children with autism who have GI problems are also prone to compulsive behaviors….The researchers' hunch proved right. Children who have more than one GI symptom are more likely than the controls to show compulsive or repetitive behavior, have a diagnosis of obsessive-compulsive disorder (OCD) or engage in ritualistic behaviors such as flipping on a light switch a specific number of times…Further analysis showed that children with constipation alone have nearly double the odds of being diagnosed with OCD….

..It's possible that constipation might somehow trigger these compulsive behaviors or, conversely, that attempts to toilet-train a child with repetitive behaviors might result in the child becoming constipated…It's possible that children who cannot speak have trouble indicating when they need to relieve themselves, triggering some of these symptoms.

Really? “ That constipation might somehow trigger these compulsive behaviors” or that “It's possible that children who cannot speak have trouble indicating when they need to relieve themselves, triggering some of these symptoms,” sounds pretty flimsy and kind of ridiculous.

I think there is plenty of evidence to show that the gut in each of these children harbors an array of microbes that are most likely causing the symptoms of OCD. The constipation is not the cause but the effect. The children and young adults, like Megan, are victims to a microbial, toxic stew, some pathogenic and causing infection, some inducing autoimmune features via antibodies and toxins.

OCD: Autism and Much More

Could this phenomenon of microbiome-induced OCD also be affecting others? Studies do show that vaccines are capable of changing the microbiome and also can cause molecular mimicry, two mechanisms that can affect the immune system and tilt it. Is this how AUTISM, PANDAS/ PANS and most likely many others, have the shared symptoms of OCD and are connected? Here’s what the research says:

That veil is only very recently being lifted with respect to a potential role for autoimmunity in neuropsychiatric disorders. This shift has occurred as evidence accumulates to support the idea that dysregulated cross-talk between the brain and the immune system is an important contributor to the pathogenesis of conditions as diverse as schizophrenia, mood disorders, autism spectrum disorders (ASDs), obsessive-compulsive disorder (OCD), Tourette syndrome and other tic disorders, attention-deficit hyperactivity disorder (ADHD), anorexia nervosa, narcolepsy, posttraumatic stress disorder and myalgic encephalomyelitis/chronic fatigue syndrome (CFS).[4,5] In addition, intriguing new evidence lends support to the possibility that not only the microbes associated with infectious episodes but also the bacteria of the gut microbiome can foster the production of brain-reactive autoantibodies, and that these microbe-induced antibodies provide the critical link between infection and neuropsychiatric disorders.

Mercury and pesticides also seem to mess with the microbiome in a very negative way. Many will point a sole finger to antibiotics as the bad guy here but too much evidence is making that choice just wrong. Mercury, all by itself, can do this- “bacterial exposure to metals such as mercury can contribute to antimicrobial resistance because many transferrable plasmids carry genes for multiple types resistance. In other words, in the process of developing metal resistance, a bacterium may also become resistant to an antibiotic it hasn’t even encountered.”

It is important to also look at the timing of autism, something Mark Blaxill and Dan Olmsted have done in their superior book, "The Age of Autism: Mercury, Medicine, and a Man-Made Epidemic." Autism made its debut when mercury in vaccines (Thimerosal) and pesticides/fungicides became part of the American landscape. Toxic chemicals have only multiplied since then and that is a huge concern. Our children who regressed into autism are the canaries of a toxic world. Are some of these other disorders with immune issues and OCD not far behind?

So it seems OCD is overlapping in some DSM diagnoses and the newest edition made a shift in 2012 to reflect some of this:

According to the American Psychiatric Association (APA), the publisher of the DSM-5, the major change for obsessive-compulsive disorder is the fact that it and related disorders now have their own chapter. They are no longer considered “anxiety disorders.” This is due to increasing research evidence demonstrating common threads running through a number of OCD-related disorders — obsessive thoughts and/or repetitive behaviors. Disorders in this chapter include obsessive-compulsive disorder, body dysmorphic disorder and trichotillomania (hair-pulling disorder), as well as two new disorders: hoarding disorder and excoriation (skin-picking) disorder.

From DSM To Your TV

Watching television shows often reminds us of how “all the world is a stage.” For example, daily on TV, we can watch different shows that have the common theme of OCD. This seems to be a newer development in the past years. Could it be on the increase?

The Big Bang Theory-The show follows a group of twentysomething genius scientists who also adhere to the textbook definition of “geeks.” Led by the egocentric Sheldon Cooper and nice-guy Leonard Hofstadter, they deal with life, love and awkward social situation with the help of next-door-neighbor Penny, the attractive and semi-normal object of Leonard’s affections.

A favorite of mine as I like all of the characters a lot and am fascinated by Sheldon’s OCD and brilliant mind, yet saddened by his lack of social skills. It has been written in articles that Sheldon DOES NOT have Asperger’s syndrome yet many still wonder about that. My title above, regarding Sheldon’s now famous knock, an OCD triple knock with a call out to “Penny” after each one, is an entertaining and humorous look at the oddness of OCD, but in real life, OCD is more often difficult and painful.

Monk- Though the series ended, the reruns continue about Monk, “a renowned former homicide detective for the San Francisco Police Department. Monk suffers from obsessive-compulsive disorder (OCD) and multiple phobias, all of which intensified after the murder of his wife Trudy,”

This description, about OCD, is on the USA Network, Information courtesy of the Anxiety Disorders Association of America .

Although a fictional character, Monk's plight is a reality for nearly 6 million Americans who suffer from OCD. These obsessions are recurring thoughts or impulses that are intrusive or inappropriate and cause the sufferer anxiety. Some common obsessions are:

•Thoughts about contamination. For example, when an individual fears coming into contact with dirt, germs or "unclean" objects.

•Persistent doubts. For example, whether or not one has turned off the iron or stove, locked the door or turned on the answering machine.

•Extreme need for orderliness.

•Aggressive impulses or thoughts. For example, being overcome with the urge to yell 'fire' in a crowded theater.

Only when the OCD sufferer performs their obsessive rituals will their anxiety subside. But relief is only temporary and so these rituals must be incorporated into the person's daily routine. Some of the most common compulsions are:

•Cleaning - Sufferers concerned with germs and contamination tend to clean constantly, either repeatedly washing their hands, showering, or constantly cleaning their home.

•Checking - Individuals may check several or even hundreds of times to make sure that stoves are turned off and doors are locked.

•Repeating - Some repeat a name, phrase or action over and over.

•Slowness - Some individuals may take an excessively slow and methodical approach to daily activities. They may spend hours organizing and arranging objects.

•Hoarding - Hoarders are unable to throw away useless items, such as old newspapers, junk mail, even broken appliances. Sometimes the hoarding reaches the point that whole rooms are filled with saved items.

Hoarders: was a US documentary series on A&E, which depicted the real-life struggles and treatment of people who suffer from compulsive hoarding.[1] The series premiered on August 17, 2009, and concluded on February 4, 2013.

Hoarding: Buried Alive: is an American documentary television series that premiered on TLC on March 14, 2010. The show follows hoarders through their life experiences and helps them learn to manage their illness.

"It's Back" is the title of last night's episode of Girls. It refers most obviously to the reappearance of Hannah's OCD, which she faced as a high school student in a pretty paralyzing form. We start the show out with Hannah counting: Counting trees, counting door-slams, counting potato chips, counting chews, everything in numbers of 8. It's back for Hannah because of the stress of writing her book, and maybe, too, because she's never really dealt with what happened with Adam. Because in life there are triggers, and often they cause us to revert back to old patterns or behaviors, even though we think we've outgrown them, treated them, or simply successfully blocked them for a while…..With Hannah, it's not just the OCD that's back. It's also her parents, who are in town and bring their own ways of relating to their daughter that have existed, presumably, for much of her life. Her dad, forgiving and ready to make excuses for her lateness; her mom, calling her on her bullshit, knowing when something's wrong. At the dinner table at The Carlyle as they wait to see Judy Collins sing, her mom notices right away, "You’re counting to 8." A second later, she defends her parenting: "We don’t know why you had OCD. It’s not our fault.” Hannah responds, "It's the ultimate your fault; it's genetic."

In Part II, we’ll look at genetics, some famous people, and an OCD sufferer reported as cured.

I can imagine how that would go over with my own son -- I had to laugh. Germ-a-phob as he is.

I am sorry about your son having thyroid at such a young age. The doctors all say - oh easy fix. Hardly -- and a big worry -- will it remain hypo -- or will become hyper - and thyroid cancer is epidmeic right now.

However: I like the fact that such fecal transplants have been known to work -- so it might not be the immune system keeping good bacteria from growing. Gives us hope dont it!

In research for reclamation of strip mines very important finding back in the late 70s was Mulch (Straw) provides food from microbes -- and microbes are necessary sprouting of seeds and the growth of grasses and -- there are very specific fungi that if not present, then pine, birches, firs and oaks will not grow -- period. Again to have these specific fungi there has to be bark and leaf mulch present. Once the trees grow and drop their leaves -- that is perfect mulch for the growth of fungi, and all is well. .

Right now the paleo diet sites on the internet are all a buzz about resistant starches. These are guys that are low glycemic - watch the carbs. I am with them considering the ketogenic diet works on epileptics and all.

Apparently there is some recent research released about mice and potato starch and being healthy.

Potatoes if cooked and then cooled forms crystals that our digestive system finds hard to breakdown, but is good food for gut microbes. Just like inulin in sun chokes.

All potatoes are not equal. The best potatoes are the ones that once cool are waxy- when cut holds their shape very well- like Pontiac reds and majestic purples has the most of the resistant starch. Potatoes that are fluffy or flour like -- has little of this resistant starch that would be the Kennabec, russet, Idaho.

I have a dog that has cushings disease from too many rabies vaccines -- developed cushings - weak back legs, limping, and became very fat days after the last vaccine.

She is a big poop eater and since we have cattle, chickens, geese and a bunch of foxes roaming around the edges of our yard -- she has plenty to poop to choose from . I don't see her getting any better from poop eating-. She seems to feel the best when I keep her from sneaking in the garage and eating cat food, and feeding her gluten free dog food mixed in with a little cooked chicken with a bit of sweet potato (for fiber) and some times -- kefir. I doubt if the kefir is doing her any good though since she has all that poop out there in the field to choose from .

Benedetta,
For people with C-Diff, a one time fecal transplant sometimes brings back good health. They may need to repeat it down the road, but their health immediately improves. I watched part of a talk (on-line) at AutismOne by a man who recovered from Crohn's disease using fecal transplants. I was disappointed to hear that it was not a one-transplant cure. He transplanted every day for quite some time. Maybe it's like you suggest, and the immune system that is damaged by vaccinations tries to kill the transplanted gut bugs and that's why so many repetitions are required. Maybe successful transplantees with C-Diff don't have the immune system issues our kids have or people with Crohn's have. If it has to be repeated so many times, I'm afraid I'll have to wait for the "microbiome in a capsule" that some clinicians in Canada are working on. I just wonder how they'll keep all those gut bugs alive in a capsule. In reality, I know my kid with thyroid issues would never submit to even one fecal transplant, so I'll have to hold out for the capsules.

Cia Parker;
I think we must be very careful of declaring something is a brain injury and nothing can be done.

The brain stem, the hypothalamus is involved that is true, but if you have B vitamins not constantly being produced in the gut - or succinate -- or even enough thyroid -- if that is true -- then it is hard to tease out what is low energy, weak muscles espcially in speech, and what is forever brain injury.

Look up and read how the deep south back in the early 1900s were in deep proverty. When they started grinding corn in a different way - taking out niacin -- sores developed in the their mouths, sore on their skin, tremors, ticks, psychosis, psychosis -- and finally death.
It took them 30 years to figure it out as they looked for an infectious disease. It is a very interesting read.

All for a B vitamin

Bs in which microbe fermentation is well know to produce.

BETTY: That would be great if it is true -- I wonder how we could find out from more than just one person on the thyroid summit saying it ??? But I want to know if we did a fecal transplant from some one healthy would the immune system run amok from a vaccine - end up killing the microbes in the fecal transplant???

They are wrong. While they are correct that these various disorders we lump together under the banner of "autism" are primarily though not exclusively genetic in nature, these genetic abnormalities are hardly normal or random. They are, for the most part, caused by environmental disruptions that occurred well before these children were conceived.

We have known for decades that genetic change can occur when environmental insults such as toxic chemicals, radiation, and endocrine disruptors impair the development of our gametes, resulting in de novo genetic or epigenetic abnormalities in the next generation.

And never in the millions of years of human evolution have we experienced a worse mass toxic event than the largely forgotten Prenatal Pharmaceutical Craze of the 20th century. Synthetic chemicals, marketed as benign little pills, were essentially poured directly into the bodies of tens of millions (probably more than that) of pregnant women around the world. I was exposed to at least three synthetic hormone drugs in utero. And you too may have been exposed to wacky and evolutionarily novel drugs during your embryonic development, the time of greatest vulnerability for our delicate germ cells. The only difference between you and me is that I have my prenatal records, and you don't. I know you don't because so few of these records from the 1950s, 60s and 70s survive.

And prenatal pharmaceuticals are just the start. Agent Orange, to which millions of Americans and Vietnamese were exposed, alters germline epigenetics. And pesticides, fungicides, flame retardants, PCBs, cigarette smoking, smog, radiation, and more and more mutagens and epimutagens that poured into our drugs, our food, our water, our air. Because these things screwed with the human germline, sometimes subtly but all too often acutely, we have epidemic of this bizarrely abnormal neurodevelopment in our kids.

Below are my slides from a March 2013 presentation about this at an autism science symposium. I think they speak for themselves, but a video of my talk will also be posted soon to the UC Davis MIND Institute website for a bit more color commentary. Lots of stuff percolating out there about germline exposures and autism, thank God (and many awesome researchers of course) for shining a light on this issue and the insanity of it all.

That said, it's incredible to me that IMFAR 2013, the world's largest autism conference, taking place next month, has almost no discussion of gamete-environment impairment in the etiology of autism spectrum disorders. It's like having a conference on babies born with flaps instead of arms and not bringing up thalidomide.

By the way, I certainly do not contend germline exposure is the only cause of the autism epidemic, but it's likely to be one of the biggies. Any thoughts or feedback can be emailed to autismhormoneproject@gmail.com.

I think there are subsets of autism. My daughter did not have bowel disease until she got a summer flu and a fever when she was seven (although she had had autism all her life from infant vaccine reactions). The fever potentiated the stored heavy metals from her vaccines as is described in The Age of Autism (book). She had severe, chronic constipation for years until I put her on the GFCF diet, then a grain-free diet. Three weeks of Saccharomyces boulardii stopped several of her GI symptoms and her constant, inappropriate laughter. She appears to be normal now as far as her GI condition: I still give her digestive enzymes before she eats anything, but it appears that she can now eat everything without a recurrence of her symptoms (touch wood).

However, she was autistic before the GI disease, and continues to be autistic now. The encephalitis caused by at least two of the few vaccines she got damaged the language and social center of her brain, and new neural circuits can be programmed to enable her to learn to use language effectively and I am trying to do so. My point is that healing the gut damage is not in itself going to correct the severe brain damage caused by the swollen brain reacting to the vaccine(s). My daughter has always been well-behaved and cooperative, but she has never had the inborn facility for absorbing and using language that an undamaged brain has, and she can understand and use very little language. I think it is very important to recognize that these are two separate problems which must be addressed in trying to heal autism.

"The constipation is not the cause but the effect."
Thumbs up.
OCD is likely not properly grasped by many as free will{as we comprehend it}and binary thinking vary in this population{imo} also depending on the particulars of an event. Excellent stuff.

Roger, you have made a good argument that part of OCD is genetic. I guess certain variations of the COMT gene are associated with OCD. People who follow Amy Yasko have been treating their spectrum kids based on COMT gene and other gene variations for several years with some success. Still, you can't have a genetic epidemic. It's still just genetic susceptibility. One of the research pieces you quote talks about a three to four fold decrease in enzymes with the COMT variation. I'll bet that was not a problem pre vaccine era as long as the correct microbiome that provides the enzymes as well was present (not sure the microbiome provides these specific enzymes, but it's a good guess - either directly or through providing vitamins or whatever else is needed to make the enzymes). I'm not saying there aren't genetic variations that result in OCD despite a healthy microbiome and no vaccinations or other toxins, but I think those variations are rare. Teresa's article suggests that the microbiome could be the reason for an increased OCD among people with susceptible genetics.

I know a family with three sons. Angelman's Syndrome was initially ruled out for one son with big developmental delays but, eventually, he was given the diagnosis of Angelman's. He's 21, but I've never understood how they could miss this genetic diagnosis even back then. One son developed a bad case of ADHD in high school, and the third son developed type 1 diabetes in high school. The father also developed ADHD as an adult. Is Angelman's a purely genetic diagnosis or are there genetics that might or might not result in Angelman's depending on the status of toxin exposure, viruses, and/or the microbiome? I wonder if some of the diseases we consider purely genetic are on the rise due to vaccines, toxins, and things that kill our gut bugs.

Roger my son has rituals - if he touches something with one hand he has to touch it with another. He is scared of germs. My son will sit in a big mess and never think of just throwing it away. He is not hoarding - he just don't put it in the trash can.

My daughter alos harmed with vaccines - Had Kawasikis -- has OCD -- on the way to school she would look and relook for something she just looked for in her back pack. Washing her hands -- constantly - she has had times washed them so much they are chapped and bleeding.

She too will sit in a mess and never clean it up -- but when she does she is a perfectionest - over cleans - ever crack and cranney. But if anything happens to me -- I fear they will end up like the hoarders -- way before hoarders on TV came on.

There have been people through out our community that are hoarders and we all know about them. It is more common than you think.

My Mother-in-law was a hoarder -- and she being a wife of a Methodist minister had to move often --

I am not sure they have a love and attachment of trash -- they just don't pick up long enough to ruin the stuff they do love.

I think you are one of us Roger It sounds like vaccine injuries have been building in your family over the past three generations.

Roger; My son was born in a hospital. A Ped gave him the reflex test and he was the highest score.

We come from an athletic family.

He walked at nine months.
My daughter walked at 10 months.
After the vaccine reaction -- at 9 months - 2 weeks -- and a few days -- he stopped walking. It was like he could not get his balance.

It took him three months of trying to get baack on his feet and his balance -- and believe me he was a determined little boy. During which he suffered two bouts of seizures - wit fever = atypical Kawaskais.

When he did walk - he walked on his toes.

If you go to parent autism meetings and at break time when the little kiddos come into the room - they all walk or run on their tip toes.
As they get older they come down off those toes and they are flat footed -- as teen agers they shake the house.

It all sounds hopeful.
It sounds like it is missing microbes.
So now the B vitamins are not being made --the history of pellegra will give you a hint how important just one B vitamin is - to the brain and nerves.
Microbes eat the carbohydrates in our guts - but without them we absorb more of the carbohydrates making us fat - and problems with insulin.

The gut microbes makes 20 percent of our thyroid hormone - I just heard this tonight on a thyroid summit - I am not sure if it is true.

Anyway the bad news is -- Mice that were fed a toxing and messed the immune sytem and was suffering from OCD - hey did not replenish the microbes -- but change out the bone marrow (not a easy thing - or a safe thing)-of a healthy mouse and the sick OCD mouse got better.

They had to change out the bone marrow where the immune system begins -- and then perhaps it allowed the microbes to come back and repopulate the gut? Not sure that was what happened, but it could be.

If so we are stuck -- we sitll will have to watch the carbohydates intake - gluten intake - take tons of vitamins to make up for the missing microbes and take probiotics -- which might do some good before our immune systems quickly kill them.

Very interesting article.I just have to tings to add.I used to have terrible OCDs,and they ere not related to vaccines or autoimmunity.My mother was also a hoarder,and a bad one at that.I lived with her junk for years and was both too low functioning and too sick to pay any attention to it.After she died,and adult protective services were called in,my landlady and I spent five weeks working all day clearing out her junk.

I know all about PANDAS/PANS and OCDs.While it may be the more common cause of OCDs in autism fanilies,it isn't the only cause.In families where methylation and metabolic problems are the main concern,COMT mutations are the main cause.I have at least two COMT mutations.My mother was not tested,but by her behavior it was clear she had them.A few articles

We recently identified a gene predisposing to OCD (PNAS 1997; 94: 4572-4575).The gene for Catechol-O-methyltransferase (COMT) is involved in the inactivation of catecholamines including the neurotransmitter dopamine, and maps to the 22q11 region. It is frequently deleted in patients with 22q11 microdeletions. There are reports that patients with these microdeletions frequently manifest with OCD (among other psychiatric phenotypes), providing evidence that the 22q11 locus harbors gene(s) predisposing to OCD. Although serotonin reuptake inhibitors (SSRIs) are the first-line pharmacotherapy for OCD, complete relief of symptoms is rare, and addition of dopamine antagonists in the therapeutic regimen appears to be useful for a subset of OCD patients, thus implicating involvement of dopaminergic pathways as well in the illness.

COMT therefore because of its function and genomic location represents an attractive candidate gene for OCD. We recently addressed the role of the COMT gene in the genetic predisposition to OCD. We show that a common functional allele of this gene (Met at codon 158) which results in a three-to-four-fold reduction in enzyme activity, is significantly associated in a recessive manner with susceptibility to OCD, particularly in males [p=0.0002 for genotypes and alleles; approximate relative risk for Met/Met versus non-Met/Met 5.91 (2.40-14.53)]. The mechanism underlying this sex-selective association remains to be defined, and may include a sexual dimorphism in COMT activity, although close linkage with a nearby disease susceptibility locus cannot be excluded at this point.

We are expanding our work to identify additional genes predisposing to OCD. Our goal is to
• understand the mode of function of COMT, and any additional genes we may identify
• understand the mode of dysfunction in disease. This effort will hopefully lead to better treatments and early intervention.http://www.rockefeller.edu/labheads/karayiorgou/linkb2.htm

All this methylation stuff is epigenetic,as is most mitochondrial disease.Our family was probably one of the first to be effected.I figure it started with my grandmother who was born around 1900.

I also have a question.AoA and Dan Olmstead have done a lot of work in digging up information on Leo Kanner's original patients.Did any of these children show signs of what we now know are signs of mitochondrial disease?A second or more later regression from sickness with fever after age three.The muscle problems associated with mito.The energy issues and crashes.I was experiencing this stuff as a child in the 1960s.Even if no one knew what was causing it at the time,these symptoms are unmistakable.

Teresa you may find this article interesting if you have not already seen, paleo blogs are gaga over microbiome these days. Note the reference to allergies and "calm" on the n=1 section. SBOs + prebiotics... wow

Trains and church bells(one particular church's bells and we don't even belong to a religious institution) have occupied Josh's daily life for 14 years(and mine too) now. He suffers from verbal OCD and repeats the same sentences over and over every day.
He has numerous(now and in the past) bacterial, viral and parasitical(a word?)entities in his body.
This piece is so good and so important. Kudos to Teresa for writing it.